Higher incidence of rejection may be due to early withdrawal of steroids
Tuesday 01, Dec 2009
According to a new study on early steroid withdrawal following transplantation of liver, there is a reduced risk of glucose intolerance and an increased incidence of rejection that may necessitate the requirement for treatment of diabetes.
The study results on early steroid withdrawal appeared in an issue of Liver Transplantation, which is the official journal of the American Association for the Study of Liver Diseases (AASLD) and the International Liver Transplantation Society (ILTS).
From News-Medical.Net:
“Although the incidence of acute rejection in the placebo group was increased, it was easily controlled in most of the cases and did not affect long-term graft histology or survival,” the authors note, adding that the increase may ultimately be acceptable if steroids could be eliminated. However, the main goal of steroid elimination is to reduce metabolic complications and this study showed no difference in cholesterol or hypertension, with a trend toward a decreased incidence of diabetes in the placebo group.
The authors conclude: “Indeed, while there are many arguments in favor of corticosteroid withdrawal beyond 3 months posttransplantation, in terms of safety and efficacy, our study demonstrates that earlier withdrawal at day 14 is not completely safe in terms of rejection, but seems efficient in terms of improvement of glucose tolerability,” which could decrease long-term mortality due to cardiovascular disease.
It is important to note here that the first double-blind placebo-controlled study was initiated for ascertaining the effects of early steroid withdrawal to ensure that all medical practitioners are on the same knowledge platform.
Tags: corticosteroid, early steroid elimination, early steroid withdrawal, steroid, steroid elimination
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